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General NPI Number Information
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NPI Number | 1417615378
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Entity Type | Individual
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Provider Name | MELISSA AFONSO DUARTE SANTOS FNP
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Gender | Female
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Dates
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Enumeration Date | 12/07/2021
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 6 BLACKSTONE VALLEY PL STE 502
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City | LINCOLN
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State | RI
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Zip | 02865-1102
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Country | US
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Telephone | 401-334-6250
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Fax |
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Provider Business Mailing Address
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Address Line | 18 LINDA ST
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City | LINCOLN
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State | RI
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Zip | 02865-2216
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN03016
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License Number State | RI
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